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� V e <br />Smith Island Facility — Sludge Disposal Site Cap Cor:struction <br />ESC Inspection Form <br />Location <br />Turbidity <br />Discoloralion <br />Sheen <br />Location <br />Turbidity <br />Disco�oration <br />stormwater <br />� <br />Includes BMP repairs, maintenance, or <br />tostaken? ❑ <br />Based on the results of fhe inspection, Ihe <br />with the terms and cor.ditions of the SWPI <br />and Notes <br />1 ceKify that this report is frue, accurete, and complete, to the bes� olmy know/edge and beliel. <br />Name Title Signature Date <br />o'teID s� iny+n.n�nlnmc. <br />Page 4 of 4 <br />